The complete or partial detachment of ligaments, tendons and/or other soft tissues from their associated bones within the body are commonplace injuries, particularly among athletes. Such injuries generally result from excessive stresses being placed on these tissues. By way of example, tissue detachment may occur as the result of an accident such as a fall, over-exertion during a work-related activity, or during the course of an athletic event. In the case of a partial detachment, the injury will frequently heal itself, if given sufficient time and if care is taken not to expose the injury to further undue stress. In the case of complete detachment, however, surgery is often needed to re-attach the soft tissue to its associated bone.
Conventional surgical procedures for repairing soft tissue detachment, e.g., ligament detachment, can employ a ligament graft to replace one or more torn ligaments. If a ligament graft is used, it can be attached to a bone using one or more sutures, which therefore must be passed around the bone to attach the ligament thereto. Passing the one or more sutures around the bone can be a time-consuming and difficult portion of the surgery, since conventional tools for passing suture around bone require the surgeon to approach the bone at an awkward angle and are often not customized for use with complex anatomies. Manipulating around complex anatomical structures can be even more difficult in minimally invasive surgery. In conventional minimally invasive procedures, surgical tools must be inserted through one or more small incisions, thus limiting visibility of the surgical site and a surgeon's ability to manipulate the surgical tools at varying angles.
For example, one common injury is acromioclavicular (“AC”) separation, in which one or more ligaments connecting the clavicle to the scapula are torn, typically by blunt force trauma. FIG. 1A shows a healthy AC joint 10, with a coraco acromial ligament 12, an acromio clavicular ligament 14, and coraco clavicular ligaments 16, 18 intact. As shown, each of the ligaments 12, 14, 16, 18 connect a clavicle 20 to a scapula 24, in particular to a coracoid process 22. FIG. 1B shows a grade III torn AC joint 10′ having undergone AC separation, in which an acromio clavicular ligament 14′ and coraco clavicular ligaments 16′,18′ have been torn, thus partially severing the connection of a clavicle 20′ to a scapula 24′. This condition can result in severe pain, swelling, and bruising.
Severe AC separations, such as the grade III separation shown in FIG. 1B, can be repaired surgically using an anatomical coracoclavicular repair (“ACCR”) technique. Conventional ACCR methods can employ a ligament graft and at least one suture affixed thereto to reattach the clavicle 20′ to the scapula 24′. To fix the ligament graft to the scapula 24′, a surgeon must typically wrap the ligament graft around the coracoid process 22′ by first manipulating the suture around the coracoid process 22′. However, conventional tools for passing the suture around the coracoid process 22′ can require a surgeon to manually manipulate the suture around the coracoid process 22′, which can involve manipulating a rigid tool at awkward angles in tight spaces. This can lead to an increased risk of tissue damage and can increase surgical time.
Accordingly, there remains a need for improved methods and devices for passing sutures around anatomical structures.